放射治疗后输尿管狭窄的临床治疗体会

N. Tabynbaev, T. Kurmanov, A. Digay, ShB. Mugalbekov, A. Mukazhanov, U. Zhanybyrbekuly, D. Mustafinov
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摘要

相关性:输尿管延伸缺损患者输尿管通畅的修复是泌尿外科最具挑战性的问题之一。输尿管放射后狭窄及医源性损伤在泌尿外科手术中非常常见。在无法借助自身组织或膀胱恢复输尿管的情况下,由于阑尾壁的结构和蠕动能力相似,可能的干预措施之一是使用阑尾。本文旨在描述阑尾输尿管成形术治疗放射后输尿管狭窄的技术。方法:本文描述了在国家癌症研究中心(努尔苏丹,哈萨克斯坦)的临床病例,手术干预,以取代部分右输尿管延长缺陷的病人。结果:本文报道一例放射治疗后输尿管延伸性狭窄患者经肠系膜阑尾手术治疗的结果。恢复上尿路尿动力学的有效性已被证明。结论:本研究结果表明,输尿管置换可降低肾积水的发生风险,改善肾脏的排泄功能。
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EXPERIENCE IN CORRECTING POST-RADIATION STRICTURE OF THE URETER BY THE VERMIX: A CLINICAL CASE
Relevance: Restoration of ureteral patency in patients with extended defects is one of the most challenging problems in urology. Post-radiation strictures and iatrogenic injuries of the ureter during surgical interventions on the small pelvis and abdominal cavity organs are quite common in urological practice. In cases where it is impossible to restore the ureter with the help of one’s own tissues or the bladder, one of the possible interventions is the use of the appendix due to the similarity in the wall’s structure and peristaltic ability. The article aimed to describe the technique of appendicoureteroplasty (AUP) for post-radiation ureteral strictures. Methods: The article describes a clinical case of a surgical intervention to replace a part of the right ureter in a patient with an extended ureteral defect at the clinic of the National Research Cancer Center (Nur-Sultan, Kazakhstan). Results: The article presents the results of surgical treatment of a patient with extended post-radiation stricture of the ureter using the appendix on the mesentery. The effectiveness of restoring the urodynamics of the upper urinary tract has been shown. Conclusions: The obtained data shows that replacing the ureter with the vermix reduces the risk of hydronephrosis and improves the kidneys’ incretory and excretory functions.
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